BOUNDARIES AND VIOLATIONS

Boundaries and Violations I: Confidentiality, Abuse/Neglect and Homicide/Suicide Reporting, Consultation, and Referral

Jared Pingleton, Psy.D.

Summary Boundaries are a God-given necessity to define and protect ourselves and our relationships.

Akin to physical property lines which define the parameters of a homeowner’s land, our boundaries let us and others know where we start and stop and where others start and stop in terms of responsibilities, privileges, limits, and much more. This course will present an overview of the essential boundaries involved in people-helping ministries.

Learning Objectives: 1. Participants will be able to define and articulate the protective benefits to the ministry of people-helping of maintaining established procedures in each of these four areas: confidentiality parameters, reporting of abuse and/or neglect and potential harm to self and/or others, consultation, and referral.

2. Will be able to offer effective guidelines in each of the above four areas which will provide a “best fit” to the practices and environmental context of people-helping ministries.

3. Will be able to effectively provide direction to a people-helping ministry for specific concerns that may arise out of each of the areas of confidentiality, abuse and neglect reporting, consultation, and referral.

I.

Introduction This course will provide non-professional people-helpers with the necessary direction and understanding to protect themselves, the client, and the church setting in which they serve so they can provide the requested assistance in an effective and efficient manner. The essential boundaries which define, protect, and regulate the helping relationship are outlined and discussed. A person cannot confidently share their heart and intimate details of their personal life (thoughts, feelings, struggles, problems, etc.) and relationships without the assurance of emotional safety and the confidence that what they share will be customarily held in strictest privacy. There are however, reasonable and necessary limitations and exceptions to the nature and degree of that privacy in certain situations, as will be outlined in this course. Additionally, the appropriate boundaries pertaining to consultation and supervision and of making referrals to other helping persons or entities will be discussed.

II.

Definitions A. Confidentiality B. Abuse and/or Neglect Reporting C. Potential Harm to Self and/or Others Reporting D. Consultation/Supervision E. Referral

III.

Confidentiality A. General Practice Considerations: 1. What is the purpose of counseling program?

2. What is the population you serve: the community at large or your church only?

3. What age of client will you be working with (parameters regarding minors)?

4. What gender(s) of clients will you be personally working with (most churches suggest same sex clients only)?

5. What safeguards exist in the physical office setting (office personnel present, doors with windows, separate waiting area from the rest of the church offices, etc.)?

6. What limits are there on sessions (is the number of sessions limited or open ended)?

7. What presenting issues/client populations are acceptable?

8. What potential dual relationships are embedded in the specific people-helping relationships you are involved in?

B. Specific Practical Considerations:

1. Develop a full and clear disclosure statement for the client to sign and date prior to the first session (covering the specific issues which warrant a breach of confidentiality) to be discussed with the client(s) in the initial session 2. What are the church discipline procedures (if any) of the church you are serving and what are the implications of those pertaining to reporting of certain behavioral sins and the limits or exclusions of confidentiality?

3. When a confidentiality breach is warranted and/or mandated, discuss the matter directly with the client, including the suspected neglect and/or abuse of children, elderly, or disabled persons, as well as potential dangers of harm to self and/or others 4. On rare occasions, your records and/or testimony may be subpoenaed or court ordered to be released. Discuss with the client that subpoenas do not have to be complied with in many states (consult with an attorney), whereas court orders are issued by a judge and carry a consequence of contempt of court if not adhered to 5. Maintenance of records: written records/session notes are to be stored in a locked file cabinet in a locked room, and are to be shredded after 7 years. Electronic records

must be passcode protected on a secure server (several secure software programs and platforms for clinical record keeping exist), and erased after 7 years.

IV.

Consultation/ Supervision A. With the client’s written permission, a release of information form will permit you to consult with a pastor, health care professional, attorney, school official, attorney, etc.

B. Everyone working with others needs supervision because we all have blind spots! There are three levels of supervision: 1. Formal supervision from a trained supervisor can be most helpful in improving your caregiving skills, enhancing your training, and developing your gifts 2. Group supervision is a time and cost efficient method to offer and receive assistance in your people-helping relationships • always recuse yourself if a colleague or fellow people-helper is seeking consultation with someone you know • only use first names • do not use any other identifying data/information about your client 3. Consulting with a colleague informally can be helpful to ensure quality care and to prevent potentially harmful outcomes so long as no identifying data is disclosed

V.

Referrals

A. No one can effectively help everyone!

B. Sometimes the best way we can help someone is to refer them to someone else who is better trained, qualified, or suited for their particular needs C. Protect the client(s) from feeling rejected or abandoned (normalize the common place necessity of referral in the helping professions, minimize any shame or stigma); follow up with them if appropriate to see if they have connected with the referral and are satisfied with the treatment D. Having a signed release form can best facilitate the procedure

E. Utilize support groups, other ancillary resources F. Utilize various Christian referral networks G. Refer to the best specialized fit for the client and their needs: • counselors • social workers • psychologists • psychiatrists